Ted Cruz, GOP senators from Medicaid expansion states will play major role in healthcare bill rewrite

Ted Cruz is likely to play a major role in shaping Senate Republicans' effort to repeal and replace the Affordable Care Act. (Gage Skidmore / CC BY-SA 2.0)

As the Senate begins work on rewriting legislation to repeal and replace the Affordable Care Act, it is starting to become clearer which lawmakers will wield the greatest influence.

One of the heavy hitters is Sen. Ted Cruz, who has evolved from his role as a GOP agitator in the Obama administration years to a more compromise-minded conservative leader, according to Politico.

After meeting in February with Sen. Lamar Alexander, R-Tenn., Cruz helped formulate the working group of Republican senators charged with drafting a new version of the healthcare bill that recently passed the House.

The group doesn’t include any true moderates—suggesting Senate Majority Leader Mitch McConnell sees conservatives as the key to building a bridge between the Senate and the hardline House Freedom Caucus, the article noted. And Cruz, who told Politico that “we wanted to ensure that the process from the outset was collaborative and inclusive,” is key to that effort.

However, it would be unwise to discount senators who didn’t make the cut for the leadership-driven working group. The 20 Republicans from states that expanded Medicaid under the ACA, The Washington Post pointed out, comprise the chamber’s most powerful bloc in terms of size and influence.

One such senator is Shelley Moore Capito of West Virginia, who hails from a state where beneficiaries of Medicaid expansion make up 10% of the population. She told the Post that senators like her have “a good voice in the process,” and said she’s working with other GOP lawmakers to ensure her constituents don’t lose access to care.

Meanwhile, some senators have offered initial clues about at least one policy issue currently under discussion. Senate Finance Committee Chairman Orrin Hatch, R-Utah, told Bloomberg that “it’s hard to say right now” whether the chamber will follow the House’s lead and repeal all the ACA’s taxes.

Some senators are worried that nixing the taxes would cause a loss in revenue that could ultimately imperil coverage for the uninsured, the article noted.

However, that would be unwelcome news for the health insurance industry, which has long called for the repeal of a tax on health plan issuers.